%0 Journal Article
%T Pregnancy-Related Acute Kidney Injury: Experience of the Nephrology Unit at the University Hospital of Fez, Morocco
%A Mohamed Arrayhani
%A Randa El Youbi
%A Tarik Sqalli
%J ISRN Nephrology
%D 2013
%R 10.5402/2013/109034
%X Introduction. Acute kidney injury (PRAKI) continues to be common in developing countries. The aim of this paper is to study AKI characteristics in pregnancy and identify the factors related to the unfavorable evolution. Methods. This prospective study was conducted in the University Hospital Hassan II of Fez, Morocco, from February 01, 2011 to January 31, 2012. All patients presenting PRAKI were included. Results. 37 cases of PRAKI were listed. Their ages varied from 20 to 41 years old, with an average of 29.03 ¡À 6.3 years and an average parity of 1.83. High blood pressure was the most common symptom (55.6%). Thirty-nine percent were oliguric. PRAKI occurred during the 3rd trimester in 66.6% of the cases and 25% of the cases in the postpartum. Hemodialysis was necessary in 16.2% of cases. The main causes were preeclampsia, hemorrhagic shocks, and functional, respectively, in 66.6%, 25%, and 8.3% of the cases. The outcome was favorable, with a complete renal function recovery for 28 patients. Poor prognosis was related to two factors: age over 38 years and advanced stage of AKI according to RIFLE classification. Conclusion. Prevention of PRAKI requires an improvement of the sanitary infrastructures with the implementation of an obligatory prenatal consultation. 1. Introduction Acute kidney injury represents a challenging clinical when it occurs during pregnancy. The worldwide incidence of pregnancy-related acute kidney injury (PRAKI) has decreased markedly in the past 50 years from 20¨C40% in 1960 to less than 10% in the current series through the legalization of abortion and improvement of antenatal and obstetric care [1]. In the recent years, the incidence of PRAKI has decreased in developed countries to only 1% to 2.8%. It is a rare complication of pregnancy following the disappearance of septic abortion and a better perinatal care [2, 3]. However, PRAKI is still frequent in developing countries; the incidence is around 4.2¨C15% [2]. Caring for women diagnosed with acute kidney injury is a real challenge for nephrologists and all the medical team. PRAKI is usually caused by septic abortion in early pregnancy, by pregnancy toxemia, hemorrhages during pregnancy (antepartum and postpartum), and acute tubular necrosis in late pregnancy [4, 5]. Acute fatty liver is an uncommon cause of PRAKI. It occurs in the third trimester of pregnancy. Puerperal sepsis and thrombotic microangiopathy are seen in the postpartum period. Acute tubular necrosis (ATN) is the most common condition with a good prognosis compared to other pathology like severe eclampsia, HELLP
%U http://www.hindawi.com/journals/isrn.nephrology/2013/109034/